Pub Date : 2022-03-29DOI: 10.26420/austinjgastroenterol.2022.1119
L. P., Torres-Ortíz V
Solitary fibrous tumors and hemangiopericytomas (SFT/HPC) are an uncommon cause of pancreatic mass, and given its rarity data is limited. In this report, we present the case of a 61-year-old Female with history of SFT/HPC brain tumor, which was evaluated with abdominal imaging after presenting with an epigastric abdominal pain. A pancreatic mass was found and after endoscopic ultrasound- fine needle aspiration biopsy, she was found with extracranial metastatic disease. Our case adds clinical awareness and knowledge to this rare entity that needs to be considered when a pancreatic mass is found.
{"title":"Pancreatic Solitary Fibrous Tumor as Result of Extracranial Metastatic Disease","authors":"L. P., Torres-Ortíz V","doi":"10.26420/austinjgastroenterol.2022.1119","DOIUrl":"https://doi.org/10.26420/austinjgastroenterol.2022.1119","url":null,"abstract":"Solitary fibrous tumors and hemangiopericytomas (SFT/HPC) are an uncommon cause of pancreatic mass, and given its rarity data is limited. In this report, we present the case of a 61-year-old Female with history of SFT/HPC brain tumor, which was evaluated with abdominal imaging after presenting with an epigastric abdominal pain. A pancreatic mass was found and after endoscopic ultrasound- fine needle aspiration biopsy, she was found with extracranial metastatic disease. Our case adds clinical awareness and knowledge to this rare entity that needs to be considered when a pancreatic mass is found.","PeriodicalId":93268,"journal":{"name":"Austin journal of gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45969614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-19DOI: 10.26420/austinjgastroenterol.2022.1118
Edderkaoui M, Chheda C, Lim A, Pandol Sj, M. R
Pancreatic cancer is one the most lethal cancers. Currently, there are reliable predictive markers to assess cancer development. Widely used CA19- 9 molecular marker has been less effective in the diagnosis of early stages of cancer.
{"title":"Co-Variation of Serum Osteoprotegerin and Pigment-Epithelial Derived Factor as Biomarker of Pancreatic Cancer","authors":"Edderkaoui M, Chheda C, Lim A, Pandol Sj, M. R","doi":"10.26420/austinjgastroenterol.2022.1118","DOIUrl":"https://doi.org/10.26420/austinjgastroenterol.2022.1118","url":null,"abstract":"Pancreatic cancer is one the most lethal cancers. Currently, there are reliable predictive markers to assess cancer development. Widely used CA19- 9 molecular marker has been less effective in the diagnosis of early stages of cancer.","PeriodicalId":93268,"journal":{"name":"Austin journal of gastroenterology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43507134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-21DOI: 10.26420/austinjgastroenterol.2021.1117
G. Q, Huang S-S, L. J., T. Y, Zhou Y, Li X-A
Aims: Healthy gut microbiome plays a crucial role in the treatment of Hepatitis B Virus (HBV) infection and chronic liver disease. Based on existing studies, we aimed to explore the difference in the efficacy of Fecal Microbiota Transplantation (FMT) in patients with different stages of HBV-related chronic liver disease. Methods: In this study, 10 HBV patients with HBeAg-negative infection, 8 patients with Chronic Hepatitis B (CHB) infection, and 8 patients with hepatitis B cirrhosis Child-Pugh score A, 9 patients with hepatitis B cirrhosis Child-Pugh score B/C were treated with FMT. Results: Our results demonstrated that continuous FMT treatment improved liver function, controlled the replication of HBV-DNA, enhanced the intestinal mucosal barrier function, relieve the degree of liver fibrosis and postponed the progression of HBV-related chronic liver disease. The result of 16S ribosomal RNA (rRNA) sequencing indicated that the individual genus and composition of the bacteria in the feces of patients gradually approached the structure seen in case of the feces of healthy donors; the number of specific Operational Taxonomic Units (OTUs) in the stool samples of patients gradually decreased. Conclusion: Our study further confirmed that FMT could be a novel and effective treatment strategy for patients with chronic HBV infection.
{"title":"Fecal Microbiota Transplantation Slows the Progression of HBV-Related Liver Diseases and Induces Virologic Response in Patients with HBV Infection","authors":"G. Q, Huang S-S, L. J., T. Y, Zhou Y, Li X-A","doi":"10.26420/austinjgastroenterol.2021.1117","DOIUrl":"https://doi.org/10.26420/austinjgastroenterol.2021.1117","url":null,"abstract":"Aims: Healthy gut microbiome plays a crucial role in the treatment of Hepatitis B Virus (HBV) infection and chronic liver disease. Based on existing studies, we aimed to explore the difference in the efficacy of Fecal Microbiota Transplantation (FMT) in patients with different stages of HBV-related chronic liver disease. Methods: In this study, 10 HBV patients with HBeAg-negative infection, 8 patients with Chronic Hepatitis B (CHB) infection, and 8 patients with hepatitis B cirrhosis Child-Pugh score A, 9 patients with hepatitis B cirrhosis Child-Pugh score B/C were treated with FMT. Results: Our results demonstrated that continuous FMT treatment improved liver function, controlled the replication of HBV-DNA, enhanced the intestinal mucosal barrier function, relieve the degree of liver fibrosis and postponed the progression of HBV-related chronic liver disease. The result of 16S ribosomal RNA (rRNA) sequencing indicated that the individual genus and composition of the bacteria in the feces of patients gradually approached the structure seen in case of the feces of healthy donors; the number of specific Operational Taxonomic Units (OTUs) in the stool samples of patients gradually decreased. Conclusion: Our study further confirmed that FMT could be a novel and effective treatment strategy for patients with chronic HBV infection.","PeriodicalId":93268,"journal":{"name":"Austin journal of gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45351674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-20DOI: 10.26420/austinjgastroenterol.2021.1116
L. L., H. S., L. S, L. Q
Purpose: This research delves into the procedure in the pathogenesis of Cisplatin (CIS)-caused liver and kidney impairment and check the defensive effect of shen-qi-di-huang decoction (SQDH). Methods: It divides adult male Wistar rats into four groups of eight animals each: Regulation; SQDH; CIS and SQDH+CIS group. They performed multiple analysis to dissect the mechanisms constraining the implements of SQDH. Results: The stems display that pretreatment with SQDH protects the rats from CIS-induced experience and kidney trauma, as disclosed by diminished degrees of serum ALT, AST, BUN and creatinine, improved histopathological damage in thriving and courage. SQDH significantly reverses CIS-induced dysregulation of apoptotic proteins in liver and kidney. In supplement, SQDH induces the activations of PI3K/AKT in kidney and p38/MAPK in liver, individually. Conclusion: We confirm that SQDH protects against CIS-induced nephrotoxicity and hepatotoxicity, which is probably correlated with the activation of p38/MAPK in liver and PI3K/AKT in kidney.
{"title":"Shen-Qi-Di-Huang Decoction Prevents Cisplatin-Induced Kidney and Liver Injury by Inhibiting Apoptosis","authors":"L. L., H. S., L. S, L. Q","doi":"10.26420/austinjgastroenterol.2021.1116","DOIUrl":"https://doi.org/10.26420/austinjgastroenterol.2021.1116","url":null,"abstract":"Purpose: This research delves into the procedure in the pathogenesis of Cisplatin (CIS)-caused liver and kidney impairment and check the defensive effect of shen-qi-di-huang decoction (SQDH). Methods: It divides adult male Wistar rats into four groups of eight animals each: Regulation; SQDH; CIS and SQDH+CIS group. They performed multiple analysis to dissect the mechanisms constraining the implements of SQDH. Results: The stems display that pretreatment with SQDH protects the rats from CIS-induced experience and kidney trauma, as disclosed by diminished degrees of serum ALT, AST, BUN and creatinine, improved histopathological damage in thriving and courage. SQDH significantly reverses CIS-induced dysregulation of apoptotic proteins in liver and kidney. In supplement, SQDH induces the activations of PI3K/AKT in kidney and p38/MAPK in liver, individually. Conclusion: We confirm that SQDH protects against CIS-induced nephrotoxicity and hepatotoxicity, which is probably correlated with the activation of p38/MAPK in liver and PI3K/AKT in kidney.","PeriodicalId":93268,"journal":{"name":"Austin journal of gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45157888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-16DOI: 10.26420/austinjgastroenterol.2021.1115
T. M., D. L
Background: The poor prognosis of Hepatocellular Carcinoma (HCC) is mainly due to late diagnosis, rapid progression and high recurrence rate. Reliable biomarkers for the diagnosis and prognosis of HCC are urgently needed. Methods: We selected four public datasets from the GEO database to identify Differentially Expressed Genes (DEGs) and Differentially Expressed miRNAs (DE miRNAs). GO functional annotation, KEGG pathway enrichment analysis, and a Protein-Protein Interaction (PPI) network were constructed to explore the functions and importance of DEGs. To determine the target genes of 33 DE miRNAs screened from GSE10694, the miRNet WebServer was utilized. The key genes were screened out by mRNA-microRNA interaction analysis. Then, those highly expressed genes were verified in parallel databases (ONCOMINE, GEPIA and HPA databases). Further prognostic analysis by Kaplan Meier and diagnostic analysis based on TCGA were conducted. Furthermore, we investigated the association between key genes and immune infiltration in HCC tissues using the TIMER database. Results: We identified seven key genes, including CCNA2, DLGAP5, MAD2L1, MELK, NCAPG, PRC1, and RRM2 based on public databases. The overexpression of these key genes has been demonstrated in HCC tissues and is associated with advanced disease and poor prognosis of patients with HCC. Furthermore, we found these key genes affect various of infiltrating immune cells and be positively correlated with the expression of gene markers of immune escape in HCC. Conclusion: These seven key genes might be used as biomarkers for the diagnosis, prognosis, and prediction response to immunotherapy for patients with HCC, as well as the therapeutic targets of HCC
{"title":"Seven Key Genes Correlated with Immune Infiltration Reveal Prognostic Significance of Hepatocellular Carcinoma","authors":"T. M., D. L","doi":"10.26420/austinjgastroenterol.2021.1115","DOIUrl":"https://doi.org/10.26420/austinjgastroenterol.2021.1115","url":null,"abstract":"Background: The poor prognosis of Hepatocellular Carcinoma (HCC) is mainly due to late diagnosis, rapid progression and high recurrence rate. Reliable biomarkers for the diagnosis and prognosis of HCC are urgently needed. Methods: We selected four public datasets from the GEO database to identify Differentially Expressed Genes (DEGs) and Differentially Expressed miRNAs (DE miRNAs). GO functional annotation, KEGG pathway enrichment analysis, and a Protein-Protein Interaction (PPI) network were constructed to explore the functions and importance of DEGs. To determine the target genes of 33 DE miRNAs screened from GSE10694, the miRNet WebServer was utilized. The key genes were screened out by mRNA-microRNA interaction analysis. Then, those highly expressed genes were verified in parallel databases (ONCOMINE, GEPIA and HPA databases). Further prognostic analysis by Kaplan Meier and diagnostic analysis based on TCGA were conducted. Furthermore, we investigated the association between key genes and immune infiltration in HCC tissues using the TIMER database. Results: We identified seven key genes, including CCNA2, DLGAP5, MAD2L1, MELK, NCAPG, PRC1, and RRM2 based on public databases. The overexpression of these key genes has been demonstrated in HCC tissues and is associated with advanced disease and poor prognosis of patients with HCC. Furthermore, we found these key genes affect various of infiltrating immune cells and be positively correlated with the expression of gene markers of immune escape in HCC. Conclusion: These seven key genes might be used as biomarkers for the diagnosis, prognosis, and prediction response to immunotherapy for patients with HCC, as well as the therapeutic targets of HCC","PeriodicalId":93268,"journal":{"name":"Austin journal of gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49516766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-21DOI: 10.26420/austinjgastroenterol.2021.1114
Tau Ja, Q. W, El-Zimaity Hmt, Opekun Ar, G. Dy
Background: Nonsteroidal anti-inflammatory drugs impair gastrointestinal ulcers healing. This study evaluated the role of cyclooxygenase isozymes COX- 1 and COX-2 in the healing of acute gastric ulcers in humans. Methods: This was an open-label, endoscopist-blind, parallel-group study, age and sex matched at baseline in normal volunteers. At endoscopy, we took four large jumbo forceps gastric mucosal biopsies (2 from each of the antrum and corpus). Subjects received celecoxib 200mg bid), naproxen 500mg bid), nabumetone 1000mg bid or placebo until end of study. Endoscopies were performed after 5 days and every 3 days until complete re-epithelialization of all lesions or 30 days. Survival analysis was used to compare time-to-healing defined as the day with complete re-epithelialization of all ulcers. Results: Fifty-two subjects completed the study, each received four biopsyinduced gastric ulcers (204 total ulcers; the majority included the muscularis mucosa). The mean time-to-healing was 9.4 ± 0.4 days with placebo, 10.5 ± 0.4 with celecoxib, 11.1 ± 0.6 with naproxen, and 12.3 ± 0.9 with nabumetone. The time to healing of each ulcer or all ulcers was significantly delayed compared to placebo with naproxen (p=0.01) and nabumetone (p=0.002) but not with celecoxib (p=0.07). Conclusion: The COX-1 preferential inhibitor naproxen and the balanced COX-1/COX-2 inhibitor nabumetone significantly delayed the healing of ulcers. With the COX-2 specific inhibitor celecoxib, healing was delayed but not significantly. Synthesis of COX-1 derived prostaglandins appears to be important in the healing of gastric ulcers in humans.
{"title":"Comparison of COX-2 Selective and Traditional NSAIDs on Experimental Gastric Ulcer Healing in Humans","authors":"Tau Ja, Q. W, El-Zimaity Hmt, Opekun Ar, G. Dy","doi":"10.26420/austinjgastroenterol.2021.1114","DOIUrl":"https://doi.org/10.26420/austinjgastroenterol.2021.1114","url":null,"abstract":"Background: Nonsteroidal anti-inflammatory drugs impair gastrointestinal ulcers healing. This study evaluated the role of cyclooxygenase isozymes COX- 1 and COX-2 in the healing of acute gastric ulcers in humans. Methods: This was an open-label, endoscopist-blind, parallel-group study, age and sex matched at baseline in normal volunteers. At endoscopy, we took four large jumbo forceps gastric mucosal biopsies (2 from each of the antrum and corpus). Subjects received celecoxib 200mg bid), naproxen 500mg bid), nabumetone 1000mg bid or placebo until end of study. Endoscopies were performed after 5 days and every 3 days until complete re-epithelialization of all lesions or 30 days. Survival analysis was used to compare time-to-healing defined as the day with complete re-epithelialization of all ulcers. Results: Fifty-two subjects completed the study, each received four biopsyinduced gastric ulcers (204 total ulcers; the majority included the muscularis mucosa). The mean time-to-healing was 9.4 ± 0.4 days with placebo, 10.5 ± 0.4 with celecoxib, 11.1 ± 0.6 with naproxen, and 12.3 ± 0.9 with nabumetone. The time to healing of each ulcer or all ulcers was significantly delayed compared to placebo with naproxen (p=0.01) and nabumetone (p=0.002) but not with celecoxib (p=0.07). Conclusion: The COX-1 preferential inhibitor naproxen and the balanced COX-1/COX-2 inhibitor nabumetone significantly delayed the healing of ulcers. With the COX-2 specific inhibitor celecoxib, healing was delayed but not significantly. Synthesis of COX-1 derived prostaglandins appears to be important in the healing of gastric ulcers in humans.","PeriodicalId":93268,"journal":{"name":"Austin journal of gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49346177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-07DOI: 10.26420/austinjgastroenterol.2021.1113
M. E, Castillo-Cano B, M. M., L. A., M. D.̂
Background: As potentially auto-immune, human papillomavirus vaccination safety surveillance includes Inflammatory Bowel Disease (IBD). We aimed to assess other risk factors among girls scheduled to vaccinate during 2007-2016 Methods: Cohort study including girls aged 9-18 years using the Spanish Primary Care Database for Pharmacoepidemiological Research (BIFAP). Adjusted Hazard ratios (HR; reported in brackets) of IBD associated with (gastroenterological and others) clinical factors were estimated. Results: Out of 388,669 girls, 185 IBD cases occurred (43.78% Crohn’s disease, 37.84% Ulcerative colitis, 18.38% undetermined). IBD increased with age, IBD family history (HR: 10.64), thyroiditis (5.07), herpesvirus infection (4.96), asthenia (1.74), while decreased with inhaled budesonide (0.38) or meningococcus B-C vaccination (0.33). Abnormal bowel movement (25.26), lower gastrointestinal bleeding (8.74), dyspepsia (7.69), abdominal pain (1.49) and spasmolytic (3.89) or antisecretory drugs (2.43) were more recorded among cases. Contraceptives (3.07), fever (2.57), infectious gastroenteritis (2.48), growth problems (2.12), chronic diarrhoea (5.37) and coeliac disease (2.07) showed almost statistical increased risk while depression or allergy showed no risk. Conclusions: The relationship between potential immune diseases and IBD varied, being high for thyroiditis, just suggested for celiac disease and lacking for allergy. The important prevalence of family history, gastrointestinal or growth conditions on IBD was confirmed.
{"title":"Prevalence of Clinical Factors before Inflammatory Bowel Disease Diagnosis among 380,000 Girls Scheduled for Papillomavirus Vaccination: A Cohort Study","authors":"M. E, Castillo-Cano B, M. M., L. A., M. D.̂","doi":"10.26420/austinjgastroenterol.2021.1113","DOIUrl":"https://doi.org/10.26420/austinjgastroenterol.2021.1113","url":null,"abstract":"Background: As potentially auto-immune, human papillomavirus vaccination safety surveillance includes Inflammatory Bowel Disease (IBD). We aimed to assess other risk factors among girls scheduled to vaccinate during 2007-2016 Methods: Cohort study including girls aged 9-18 years using the Spanish Primary Care Database for Pharmacoepidemiological Research (BIFAP). Adjusted Hazard ratios (HR; reported in brackets) of IBD associated with (gastroenterological and others) clinical factors were estimated. Results: Out of 388,669 girls, 185 IBD cases occurred (43.78% Crohn’s disease, 37.84% Ulcerative colitis, 18.38% undetermined). IBD increased with age, IBD family history (HR: 10.64), thyroiditis (5.07), herpesvirus infection (4.96), asthenia (1.74), while decreased with inhaled budesonide (0.38) or meningococcus B-C vaccination (0.33). Abnormal bowel movement (25.26), lower gastrointestinal bleeding (8.74), dyspepsia (7.69), abdominal pain (1.49) and spasmolytic (3.89) or antisecretory drugs (2.43) were more recorded among cases. Contraceptives (3.07), fever (2.57), infectious gastroenteritis (2.48), growth problems (2.12), chronic diarrhoea (5.37) and coeliac disease (2.07) showed almost statistical increased risk while depression or allergy showed no risk. Conclusions: The relationship between potential immune diseases and IBD varied, being high for thyroiditis, just suggested for celiac disease and lacking for allergy. The important prevalence of family history, gastrointestinal or growth conditions on IBD was confirmed.","PeriodicalId":93268,"journal":{"name":"Austin journal of gastroenterology","volume":"220 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91395536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-11DOI: 10.26420/austinjgastroenterol.2021.1112
K. Kumar, S. Fukuchi, K. Murakami
We often encounter complications from biliary stents used as a treatment for obstructive jaundice and acute cholangitis. Early complications after stent placement include pancreatitis, bleeding, and duodenal perforation [1]. Stent deviation is also a complication. This is particularly prominent for plastic stents, where stent deviation is observed in 6-18.7 % of cases [2]. Stent deviation is more common among patients who have undergone endoscopic sphincterotomy (Figure 1). Most deviated biliary plastic stents are excreted in stool or collected endoscopically, but, very rarely, complications causing gastrointestinal perforation have been reported. We have described deviated biliary plastic stents causing sigmoid colon diverticulum perforation and even uterine appendage penetration (Figure 2). Diagnosis can be made from clinical symptoms and abdominal computed tomography. Treatment is basically surgery. Biliary stent-related complications are inevitable, and sometimes become serious. On suspicion of such complications, the most important issue is to accurately and rapidly diagnose complications and conduct appropriate management.
{"title":"Complications due to Biliary Stent Deviation","authors":"K. Kumar, S. Fukuchi, K. Murakami","doi":"10.26420/austinjgastroenterol.2021.1112","DOIUrl":"https://doi.org/10.26420/austinjgastroenterol.2021.1112","url":null,"abstract":"We often encounter complications from biliary stents used as a treatment for obstructive jaundice and acute cholangitis. Early complications after stent placement include pancreatitis, bleeding, and duodenal perforation [1]. Stent deviation is also a complication. This is particularly prominent for plastic stents, where stent deviation is observed in 6-18.7 % of cases [2]. Stent deviation is more common among patients who have undergone endoscopic sphincterotomy (Figure 1). Most deviated biliary plastic stents are excreted in stool or collected endoscopically, but, very rarely, complications causing gastrointestinal perforation have been reported. We have described deviated biliary plastic stents causing sigmoid colon diverticulum perforation and even uterine appendage penetration (Figure 2). Diagnosis can be made from clinical symptoms and abdominal computed tomography. Treatment is basically surgery. Biliary stent-related complications are inevitable, and sometimes become serious. On suspicion of such complications, the most important issue is to accurately and rapidly diagnose complications and conduct appropriate management.","PeriodicalId":93268,"journal":{"name":"Austin journal of gastroenterology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42180487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-10DOI: 10.26420/AUSTINJGASTROENTEROL.2021.1111
Poulos Je, B. Ingram, Milanov, M. Conti, T. Ingram, E. Poulos
An estimated 3.5 million people have Chronic Hepatitis C (CHC) in the United States [1]. With the current opioid epidemic, the number of people who are injecting drugs in the US. Has substantially increased the incidence of CHC virus [2]. With an apparent second wave of CHC, it will be important to manage the sequelae of these chronically infected patients and recognize associated comorbidities. CHC has been shown to increase the risk of hepatocellular carcinoma and has been linked to such malignancies as Non-Hodgkin lymphoma, cholangiocarcinoma, breast, pancreatic, renal, skin/oral, thyroid, and colon cancer [3-6]. Colon cancer is the second leading cause of cancer-related death in men in developed countries and the third most prevalent cause of death from cancer for women [7]. Colorectal Cancer (CRC) screening has been shown to reduce the risk for the development of CRC and prevent the development of more advanced disease [8,9]. The risks for developing colorectal cancer are associated with increasing age, family history, history of adenomas or Inflammatory Bowel Diseases (IBD) and ethnicity. Other possible risk factors include a high fat, low-fiber diet, obesity, smoking, and excessive alcohol use. A possible link between colon cancer and CHC has not been extensively studied. However, previous studies have suggested that patients with CHC have a higher risk of colonic adenomas and more advanced lesions. Thus, the goal of this study was to determine if patients with CHC undergoing screening or surveillance colonoscopies in a community setting have an increased risk of colonic neoplasia.
{"title":"Chronic Hepatitis C as a Risk Factor for Colonic Neoplasia in a Community Setting","authors":"Poulos Je, B. Ingram, Milanov, M. Conti, T. Ingram, E. Poulos","doi":"10.26420/AUSTINJGASTROENTEROL.2021.1111","DOIUrl":"https://doi.org/10.26420/AUSTINJGASTROENTEROL.2021.1111","url":null,"abstract":"An estimated 3.5 million people have Chronic Hepatitis C (CHC) in the United States [1]. With the current opioid epidemic, the number of people who are injecting drugs in the US. Has substantially increased the incidence of CHC virus [2]. With an apparent second wave of CHC, it will be important to manage the sequelae of these chronically infected patients and recognize associated comorbidities. CHC has been shown to increase the risk of hepatocellular carcinoma and has been linked to such malignancies as Non-Hodgkin lymphoma, cholangiocarcinoma, breast, pancreatic, renal, skin/oral, thyroid, and colon cancer [3-6]. Colon cancer is the second leading cause of cancer-related death in men in developed countries and the third most prevalent cause of death from cancer for women [7]. Colorectal Cancer (CRC) screening has been shown to reduce the risk for the development of CRC and prevent the development of more advanced disease [8,9]. The risks for developing colorectal cancer are associated with increasing age, family history, history of adenomas or Inflammatory Bowel Diseases (IBD) and ethnicity. Other possible risk factors include a high fat, low-fiber diet, obesity, smoking, and excessive alcohol use. A possible link between colon cancer and CHC has not been extensively studied. However, previous studies have suggested that patients with CHC have a higher risk of colonic adenomas and more advanced lesions. Thus, the goal of this study was to determine if patients with CHC undergoing screening or surveillance colonoscopies in a community setting have an increased risk of colonic neoplasia.","PeriodicalId":93268,"journal":{"name":"Austin journal of gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44723891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-11DOI: 10.26420/AUSTINJGASTROENTEROL.1097.2019
A. Elsaady
In spite of its commonality, there is no universal standard in the management of appendicular mass. This study is a prospective one, aiming at comparing the different modalities of management in terms of efficacy and safety. Over seven years, all patients presented with appendicular mass were involved in the study, where they were divided into four groups; conservative management with routine interval appendectomy (group A), conservative treatment without interval appendectomy as a routine (group B), operative interference at the initial admission (group C), & laparoscopic exploration (group D). The study assessed the efficacy, complications, difficulties encountered in operative groups, rate of recurrence, hospital stay, and durations of treatment. 169 cases were presented in this study. The conservative management was successful in about 88% patients Appendectomy was done in all patients of group A, C & D, and only 18% in group B need appendectomy, Appendectomy was done in two settings (drainage then appendectomy) in ~5% of group A, ~4% of group B, 14% of group C, and 27% of patients in group D. The hospital stay & duration of treatment were >2 folds more in conservative groups (A&B) than intervention groups (C&D). Difficulties in operations were reported more in intervention groups (c &d), where consultant was needed in all cases of group D, 2/3 of group B , and only 1/3 of group B & 7% in group A. There was no significant difference in operative difficulties between patient failed conservative measures and interventional group from the start (group C&D). The study concluded that; although there is a debate in the best modalities of treatment of appendicular mass, the conservative approach is still a quite effective & safe method of treatment, with no significant operative difficulties in failed group. The rate of recurrence after successful conservative management is low to justify interval appendectomy as a routine. CT & or colonoscopy is preferred to be done after relief of acute attacks to avoid missing another pathology. The laparoscopic approach seem to be promising, with early recovery as well as diagnostic superiority for a hidden pathology. It may become the best modality with the growing of the learning curve.
{"title":"Management of Appendicular Mass; Comparative Study between Different Modalities","authors":"A. Elsaady","doi":"10.26420/AUSTINJGASTROENTEROL.1097.2019","DOIUrl":"https://doi.org/10.26420/AUSTINJGASTROENTEROL.1097.2019","url":null,"abstract":"In spite of its commonality, there is no universal standard in the management of appendicular mass. This study is a prospective one, aiming at comparing the different modalities of management in terms of efficacy and safety. Over seven years, all patients presented with appendicular mass were involved in the study, where they were divided into four groups; conservative management with routine interval appendectomy (group A), conservative treatment without interval appendectomy as a routine (group B), operative interference at the initial admission (group C), & laparoscopic exploration (group D). The study assessed the efficacy, complications, difficulties encountered in operative groups, rate of recurrence, hospital stay, and durations of treatment. 169 cases were presented in this study. The conservative management was successful in about 88% patients Appendectomy was done in all patients of group A, C & D, and only 18% in group B need appendectomy, Appendectomy was done in two settings (drainage then appendectomy) in ~5% of group A, ~4% of group B, 14% of group C, and 27% of patients in group D. The hospital stay & duration of treatment were >2 folds more in conservative groups (A&B) than intervention groups (C&D). Difficulties in operations were reported more in intervention groups (c &d), where consultant was needed in all cases of group D, 2/3 of group B , and only 1/3 of group B & 7% in group A. There was no significant difference in operative difficulties between patient failed conservative measures and interventional group from the start (group C&D). The study concluded that; although there is a debate in the best modalities of treatment of appendicular mass, the conservative approach is still a quite effective & safe method of treatment, with no significant operative difficulties in failed group. The rate of recurrence after successful conservative management is low to justify interval appendectomy as a routine. CT & or colonoscopy is preferred to be done after relief of acute attacks to avoid missing another pathology. The laparoscopic approach seem to be promising, with early recovery as well as diagnostic superiority for a hidden pathology. It may become the best modality with the growing of the learning curve.","PeriodicalId":93268,"journal":{"name":"Austin journal of gastroenterology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44580618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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